Fish Oil and Psychotic Disorders

A new study suggests that fish oil may be beneficial in adolescents and young adults who are at risk of developing psychotic disorders.

Some earlier evidence suggests that omega-3 fatty acids may have positive effects on various psychiatric illnesses, such as depression and schizophrenia. Since using antipsychotic medicine to prevent psychotic disorders is controversial, researchers set out to test the preventative effects of fish oil supplements, which are rich in fatty acids and have few side effects when used appropriately.

The study included 81 people who had low-level psychotic symptoms, transient psychotic symptoms, a schizophrenia-like personality disorder or a close relative with schizophrenia. The participants were 13-25 years old and all experienced a drastic decline in mental function within the last year.

The subjects were randomly assigned to receive fish oil supplements that contained 1.2 grams of omega-3 fatty acids or placebo daily for 12 weeks. The researchers monitored the participants for 40 weeks after treatment, and a total of 76 people completed the study.

By the end of the follow-up period, just five percent of people in the omega-3 group developed a psychotic illness compared to 28 percent in the placebo group. Additionally, people in the omega-3 group experienced significant improvements in psychotic symptoms and mental function.

Although promising, additional research is needed to confirm these findings and determine a potential mechanism of action.

Fish oil supplements are commonly taken to help prevent heart disease. Supplementation has been shown to help lower triglyceride levels and blood pressure, reduce mortality rates and abnormal heart rhythms, and prevent strokes and atherosclerosis. However, high doses may have harmful effects, such as an increased risk of bleeding.

To learn more about omega-3 fatty acids, please visit Natural Standard's Foods, Herbs & Supplements database.

Comments

[mburns]

These results do seem promising! I am looking forward to more studies in the area of the potential benefits of fish oil in people at risk for psychotic disorders. I was familiar with the idea that the omega-3 fatty acids present in fish oil are beneficial for mental function because I remember hearing about them being added to baby formulas for that reason. Being a vegetarian, I’m curious if other sources of these fatty acids, such as flaxseed oil, will measure up to fish oil in this area.

[Doc Haki]

Fatty acids, DHA and EPA are helpful for mood and psychoses. They are mildly helpful, but that is not bad, given the potential to decrease and taper down with caution the neuroleptics, mood agents and other meds with really serious side effects.

However, as far as this particular study is concerned, the sample size is a bit small. The selection criteria are confused and muddled up. There is a vagueness as to how risk was estimated. Some of the patients may be pre-psychotic, but others seem to have personality disorders of the BPD type that can have very brief psychotic reactions, while others still may have schizoid personality types that can move on to a full fledged schizophrenia. Hence, fish oil cannot be given to all these heterogeneous diagnoses and assumed to be helpful at the tiny dose of 1.2 grams daily.

On top of all these above areas of weakness, it is not mentioned if other supplements or exercising or group or individual support have all been accounted for amongst the patients.

Although iIstrongly encourage the use of fish oil in all mood and other psychoses, I believe this current study needs to be repeated, but with many improvements and refinements to be more convincing.

Clinically though, I believe fish oil is well worth adding to the patients regimen

[steve koelzer]

By 1981, Dr. Ralph Holman published a report on omega-3 essential oils and interfering trans-fatty acids. Then Dr. Donald Rudin published omega-3 research for bipolar, agorophobia and paranoia. A decade later, another Harvard dr., Andrew Stoll, published "omega-3 connection." Now, from Vienna comes the results of research performed from 2004 to 2007. I guess that one has to undergo a change in diet to be able to understand or believe it's true (or both!). Perhaps flax or fish oil should be dispensed by prescription but not only to elderly rich for longevity.

[Sara Z]

I wonder if fish oil has any effect on other aspects of mental well-being such as preserving memory and preventing neurodegenration. Also, it would be interesting to see a general study on those who regularly take fish oil versus those who do not to see what the difference in mental health is.

[SK]

The results of this study are very promising for those who are at risk for developing psychotic disorders. The medications to treat psychotic disorders come with many side effects that adversely affect the patient’s quality of life, such as weight gain, drowsiness, blurred vision, and rapid heartbeat. If fish oil can be used to prevent the development of psychotic disorders later in life and come with the added benefit of improved cardiovascular health, it is something that needs to be explored further. Although this study was only performed in a hospital population in Vienna, the results are promising. It will be interesting to see the results of a larger study, with a more varied population.

[zoes_mama]

This is a very interesting study on the effect of the omega-3 fatty acid. However, it is unclear whether this therapy is used to prevent these disorders or to treat them. Based on the description of the study, it looks like the omega-3 fatty acid was used to treat the disorders, especially since many (if not all) of the subjects already experienced a drastic decline in mental function. I guess the the researchers were trying to see whether this supplement could prevent any further psychotic developments, but it seems to me the distinction is rather fuzzy.

In any case, the study showed great results, especially since the side effects of fish oil are much milder compared to the the traditional anti-psychotic medications.

[Sushi Lover]

Is there nothing that omega-3 fatty acids are not good for? Salmon truly is a superfood. With regard to this study, it would be interesting to note the incidence of psychotic disorders in high fish-consuming populations, such as the Norwegians or Japanese, relative to the average.

[as_pharm_student]

The possibility of preventing or treating psychotic disorders with fish oil is intriguing. I agree with Doc Haki’s assessment of the study’s methodological shortcomings, and I also think this area should be explored with more rigorous studies, particularly over a longer timeframe. How long do any protective benefits of a 12-week course of fish oil last? Does taking fish oil for a longer period confer greater protection? Would high-risk patients be less likely to develop psychoses with chronic fish oil therapy over a lifetime?

[Sara]

Just attended a journal club discussing this article. Apparently, treatment with fish oil did not necessarily improve the subjects' mental function. The fish oil could have delayed the onset of psychotic events; however, the length of the study was not long enough to confirm that finding. It would be interesting to see another larger study of longer duration.

[Interested Student]

This is very interesting. I looked at the statistics for the patients in the fish oil group versus the placebo group (each having about 40 patients). I noticed that the placebo group (who did not receive anything to supplement their condition) had about 6 more smokers in their group. This is a big difference when considering that there was about 9 more patients in this group that developed worsening symptoms of psychosis. My question is: "How do we know what affected the outcome? Was it the fact that a larger percent of them were smokers or that they did not receive fish oil?" These are questions that can be hashed out by conducting a bigger, more comprehensive study.

[KTR]

I agree with the rest of the comments that there needs to be more well-conducted, well-designed studies involving omega-3 fatty acids and other fish oils to understand their potential role in treating and preventing mood disorders. Omega-3 fatty acids are already so beneficial for cardiac health and hypertriglyceridemia that it would be great to see them be beneficial in other diseases, such as psychosis, especially since they are overall minimally toxic.

Even in the case of toxicity, the most concerning adverse effect is increase risk of bleeding seen mostly in very large doses such as 3g of DHA or 10g of fish oil. This would be cause for concern in patients who may be taking anticoagulants or have clotting disorders. However, the likelihood of teens and young adults taking anticoagulants is probably not as high as older populations. Overall, i would say that this study is one of the first steps toward discovering another promising use of fish oils.

[Doratheexplorer]

More research is needed to definitively tell whether fish oil has promising effects on psychosis. All of the previously mentioned concerns regarding this study (i.e. patient sample size, inclusion/exclusion criteria and study duration) are correct. Although fish oil does have beneficial effects on other conditions, I am hesitant to add prevention of psychosis to the list.

[STruong]

Recently, the popularity of fish oil has been increasing, and more studies have been done. I had read a study about fish oil delaying the psychosis disorder symptoms in adolescents. And the result showed that fish oil can delay the recurrence of the disorder within 1 year; however, it does not seem to improve the function of psychostic patients. Therefore, further studies need to be done before fish oil can have an indication for preventing psychotic disorders.

[Dexter Morgan]

Sushi Lover has a point!!! Well played.

[jesse james]

In regard to the comment Sushi Lover posted about Salmon being a super food, I agree! According to the Natural Standard database, fish oil has strong scientific evidence (grade A) for hypertension, secondary cardiovascular disease prevention and hypertriglyceridemia, as well as a few indications with good scientific evidence in support (grade B). Everyone should eat more fish!

[Jack Sparrow]

We have known for quite some time that fish oils are good for heart health. It is interesting to note that there may be more beneficial outcomes for other health states.

I also find it intriguing that this was used as a preventative measure, as many individuals will postpone medical therapy until the disease state has progressed to the point where it affects daily life. Although this study is only very small and of short duration, it will be interesting to see where the research will progress from here.

[rs__pharm student]

This idea of preventing psychotic disorders seems pretty promising, if done right and in safe amounts of fish oil. I think the difficulty of this will be monitoring correctly for patients at high risk of psychotic disorders. There are set criteria to diagnose these disorders that are already somewhat subjective, so screening for high-risk patients may be even more difficult to do.

The study did seem to have some promising results and definitely warrants future studies. Determining the mechanism of action that this works through would be a huge help in deciding if this is helpful.

[Jenny L]

A great approach for preventing psychosis is using supplements. I believe fish oil with a high concentration of omega-3 can help prevent psychosis by maintaining brain function and improving circulation. Many anti-psychotic medications also pose a risk for metabolic syndromes; fish oil can be added to the regimen to improve a person's lipid profile. I do not believe fish oil can decrease LDL, but it can help lower triglycerides and increase HDL.

[Kristine A]

This is an interesting study. The dose they used (1.2g/day of fish oil) seems to be a bit low compared to the recommended dose (2-4g/day). I wonder if increasing the dose can offer a better prevention for psychotic disorders. The lipid benefits are not very well demonstrated in people who are 60 years or older, but if the study stands true, fish oil can offer great benefits for elders since many of them show declined mental status. It would be interesting to see if there are studies done for that.